Pneumococcal disease during Hajj and Umrah: Research agenda for evidence-based vaccination policy for these events

Yezli, Saber; Linden, Mark van der; Booy, Robert; Alotaibi, Badriah

doi:10.1016/j.tmaid.2018.08.005

Cited by 6 publications

(6 citation statements)

References 81 publications

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“…In particular, it may be possible to validate that the influenza serotypes found are representative of strains circulating during the prior northern winter. These data also may provide justification for recommending pneumococcal vaccination for some high-risk travelers [19][20][21]. However, one-third of all travelers in this report did not attend a pre-travel consultation, and this will likely be a barrier to implementation of such recommendations.…”

Section: Discussionmentioning

confidence: 82%

“…The top three specific MGs were Umrah or Hajj in Saudi Arabia with 241 cases (81.4%), including 87 at Umrah and 154 at Hajj, followed by the World Scout Jamboree in Japan with 17 cases (5.7%), and the Olympics in Brazil and South Korea with 9 cases (3.1%) ( Table 1). Ill travelers who acquired illness at Umrah or Hajj were older (median age: 57 years [range: 1-88; IQR: 47-66]) than those at the Olympics (median age: 36 years [range: ; IQR: 31-46]) or the World Scout Jamboree (median age: 18 years [range: 14-52; IQR: [17][18][19][20]). Sixty-four percent of ill travelers who attended Umrah or Hajj were hospitalized because of their illness; one traveler who attended the World Scout Jamboree and no travelers who attended the Olympics were hospitalized.…”

Section: Resultsmentioning

confidence: 99%

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International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

Angelo

Ásgeirsson

Duvignaud³

et al. 2019

Travel Medicine and Infectious Disease

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A B S T R A C TBackground: Travelers to international mass gatherings may be exposed to conditions which increase their risk of acquiring infectious diseases. Most existing data come from single clinical sites seeing returning travelers, or relate to single events. Methods: Investigators evaluated ill travelers returning from a mass gathering, and presenting to a GeoSentinel site between August 2015 and April 2019, and collected data on the nature of the event and the relation between final diagnoses and the mass gathering. Results: Of 296 ill travelers, 51% were female and the median age was 54 years (range: 1-88). Over 82% returned from a religious mass gathering, most frequently Umrah or Hajj. Only 3% returned from the Olympics in Brazil or South Korea. Other mass gatherings included other sporting events, cultural or entertainment events, and conferences. Respiratory diseases accounted for almost 80% of all diagnoses, with vaccine preventable illnesses such as influenza and pneumonia accounting for 26% and 20% of all diagnoses respectively. This was followed by gastrointestinal illnesses, accounting for 4.5%. Sixty-three percent of travelers reported having a pre-travel encounter with a healthcare provider. Conclusions: Despite this surveillance being limited to patients presenting to GeoSentinel sites, our findings highlight the importance of respiratory diseases at mass gatherings, the need for pre-travel consultations before mass gatherings, and consideration of vaccination against influenza and pneumococcal disease.

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Section: Discussionmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 99%

International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

Angelo

Ásgeirsson

Duvignaud³

et al. 2019

Travel Medicine and Infectious Disease

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“… Streptococcus pneumoniae in Hajj is usually associated with pneumonia, a lower respiratory tract infection [38]. Moreover, it is the leading cause for respiratory hospital admissions during Hajj [23, 37].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the rate, pattern and appropriateness of antibiotic prescription in a cohort of pilgrims suffering from upper respiratory tract infection during the 2018 Hajj season

Bokhary

Team

Barasheed

et al. 2022

Access Microbiology

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Hajj is associated with an increased risk of the transmission of infectious diseases including upper respiratory tract infections (URTIs). It can be a focal point for the emergence, persistence and dissemination of antimicrobial-resistant (AMR) bacteria. The overuse of antibiotics during Hajj can promote the development of antimicrobial resistance. Little information is known regarding the true appropriateness of prescribing antibiotics for treating URTIs during Hajj. Here we studied the rate, patterns and appropriateness of antibiotic prescription among a cohort of pilgrims who were treated for URTIs during the 2018 Hajj season. Adult pilgrims who sought medical services for URTIs [presenting with coryza, runny nose, nasal irritation, nasal congestion, cough, sore throat, headache or fever (even if subjective)] within the Holy sites were enrolled in this study and consented to provide swabs and medical information. A total of 121 pilgrims were enrolled, with the majority (60.3 %) originating from North African Arab countries. Most were male (89.3 %) with a median age of 45 years. Bacterial infections were detected in 7.3 % (n=9) of the URTI cases. The identified bacteria included Haemophilus influenzae (n=6, all resistant to ampicillin), Streptococcus pneumoniae (n=2), Staphylococcus aureus (n=1, resistant to oxacillin) and Moraxella catarrhalis (n=1, resistant to ampicillin and trimethoprim/sulfamethoxazole). The antibiotic prescription rate was 52.1%, most of which was amoxicillin (81 %). The data demonstrated that the proportion of appropriate practices in treating bacterial URTIs in this cohort was 45.5 %. This study highlights the need for implementing laboratory identification of the aetiological agents and related AMR profiles when treating URTIs in Hajj, rather than relying on clinical assessment alone.

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“…72,73 Additionally, religious mass gatherings occurring within this region act as hotspots for pathogen dissemination among pilgrims (especially those with comorbidities) during Hajj, Umrah, and Arba'een. [74][75][76][77] Thus, the active surveillance of pneumococcal serotypes prevalent within this region would help determine the effectiveness of the adopted immunization strategies and aid in developing novel measures to control disease transmission and outbreaks. Currently, the EMR has a vaccination coverage of 52% for 3 doses of PCV.…”

Section: S Pneumoniae Serotypesmentioning

confidence: 99%

Emerging pneumococcal serotypes in Iraq: scope for improved vaccine development

Dawood

Al-Jumaili²,

Radhi³

et al. 2023

F1000Res

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Pneumococcal disease is a global public health concern as it affects the young, aged and the immunocompromised. The development of pneumococcal vaccines and their incorporation in the immunization programs has helped to reduce the global burden of disease. However, serotype replacement and the emergence of non-vaccine serotypes as well as the persistence of a few vaccine serotypes underscores the need for development of new and effective vaccines against such pneumococcal serotypes. In the Middle East, places of religious mass gatherings are a hotspot for disease transmission in addition to the global risk factors. Therefore, the periodic surveillance of pneumococcal serotypes circulating in the region to determine the effectiveness of existing prevention strategies and develop improved vaccines is warranted. Currently, there is a lack of serotype prevalence data for Iraq due to inadequate surveillance in the region. Thus, this review aims to determine the pneumococcal serotypes circulating in Iraq by drawing inferences from the global pneumococcal serotype prevalence data as well as recently published literature from neighboring countries to refine existing vaccination strategies and help in the development and introduction of improved pneumococcal vaccines in the country.

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Pneumococcal disease during Hajj and Umrah: Research agenda for evidence-based vaccination policy for these events

Cited by 6 publications

References 81 publications

International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

Evaluation of the rate, pattern and appropriateness of antibiotic prescription in a cohort of pilgrims suffering from upper respiratory tract infection during the 2018 Hajj season

Emerging pneumococcal serotypes in Iraq: scope for improved vaccine development

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